What is IBS?
Irritable Bowel Syndrome (IBS) is a chronic disorder of the large intestine characterized by recurrent abdominal pain, bloating, and altered bowel habits such as diarrhea, constipation, or a mix of both. IBS is a functional disorder, which means that rather than being caused by a structural abnormality, it is an issue with how the digestive system works.
IBS is a functional disorder, which means that rather than being caused by a structural abnormality, it is an issue with how the digestive system works.
Gut-Brain Axis: the link between IBS and mental health
The bidirectional communication between the gastrointestinal system and the brain has coined the term "gut-brain axis."
The gut is often called the "second brain" because it contains millions of neurons that produce neurotransmitters like serotonin, which plays a crucial role in mood regulation. This connection suggests that mental health can influence gut function and vice versa.
The extensive network of neurons that govern the gastrointestinal tract is called the enteric nervous system (ENS), which is connected to the brain via the vagus nerve. Individuals with IBS can have hypersensitivity to the ENS, thereby amplifying the pain and discomfort of normal digestive processes.
Prevalence of mental health disorders in IBS
Research has highlighted that individuals with IBS are at increased risk for developing mental health disorders, such as anxiety and depression. Studies have shown that up to 40-60% of people with IBS also experience anxiety or depression.
Studies have shown that up to 40-60% of people with IBS also experience anxiety or depression.
The symptoms that come with IBS, when severe or chronic, often lead to significant distress and interfere with normal daily functioning. This creates a vicious cycle where IBS leads to poor mental health, and having poor mental health exacerbates gastrointestinal symptoms.
Individuals with IBS may develop anxiety from eating, traveling, or attending social events due to the unpredictability of their symptoms. The fear of a flare-up in public leads to anxious and avoidant behaviors. As a result of their ailment, individuals with IBS experience social isolation, which, over time, can lead to depression and worsening of their symptoms.
Read more on the Gut-Brain connection from the Cleveland Clinic
Mental health and its impact on gut function
Activation of the stress response
The hypothalamic-pituitary-adrenal (HPA) axis is activated when you experience stress, anxiety, or depression. This leads to the release of stress hormones, primarily cortisol.
Chronically elevated levels of cortisol can cause gut motility dysfunction and lead to issues like diarrhea or constipation.
Increased gut permeability
Prolonged stress or depression can increase the gut's permeability, allowing harmful substances (like undigested food particles, toxins, and bacteria) to pass into the bloodstream.
This process triggers inflammation throughout the body and can worsen symptoms of IBS.
Gut microbiome and dysbiosis
When the harmful bacteria outnumber the good bacteria in the gut, it is called dysbiosis.
Dysbiosis has been linked to anxiety and depression, two mental health conditions that can exacerbate IBS symptoms and contribute to the vicious cycle.
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Private Healthcare Navigation and Patient Advocacy when YOU need it mostManagement & Treatment
Due to the bidirectional relationship between IBS and mental health, management requires an integrated approach that can address both the physical and psychological aspects of these conditions. Below, we explore a variety of psychological, pharmacological, and dietary interventions.
Cognitive Behavioral Therapy (CBT)
It helps reframe negative thinking and build coping strategies for psychological and physical discomfort.
Addresses anxiety and stress, which are common triggers for IBS flare-ups.
Gut-directed Hypnotherapy
It involves guided relaxation techniques that help individuals gain more control over their bodily sensations and reduce stress.
Addresses the enteric nervous system hypersensitivity seen in IBS - helps reduce abdominal pain & bloating.
Antidepressants (Serotonin Reuptake Inhibitors/Serotonin-Norepinephrine Reuptake Inhibitors)
By increasing serotonin & norepinephrine levels, these medications can reduce symptoms of depression & anxiety.
Healthy levels of serotonin help to regulate gut motility and alleviate IBS symptoms.
Low FODMAP diet
FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, short-chain carbohydrates poorly absorbed in the small intestine and fermented in the colon.
By eating foods low in FODMAPs, individuals can reduce bloating, gas, and abdominal discomfort, leading to a better quality of life.
Wellstar MCG Health Medical Center Explains IBS | Check out this video.
Key takeaways
IBS is a functional disorder of the gastrointestinal tract characterized by recurrent abdominal pain, bloating, and altered bowel habits.
An extensive network of neurons in the gastrointestinal tract forms the enteric nervous system, also known as "the second brain."
The enteric nervous system is connected to the brain via the vagus nerve, forming the "gut-brain axis." This connection suggests that mental health can influence gut function and vice versa.
Individuals with IBS are at an increased risk of developing anxiety and depression that can go on to exacerbate the symptoms associated with their disease.
Mental health disorders can impact gut function by activating the stress response, increasing gut permeability, and disrupting the microbiome (dysbiosis).
CBT, gut-directed hypnotherapy, antidepressants, and a low FODMAP diet can help to address IBS symptoms and thereby improve quality of life.
Personally
I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.
"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"
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